Current evidence suggests that monkeypox is primarily spread through direct contact with the infectious rash, scabs or bodily fluids of a person who has the virus. People with monkeypox in the current outbreak generally report having had close, sustained physical contact with other people who have monkeypox.
Monkeypox can also be spread through prolonged, close face-to-face contact — think kissing, cuddling or other intimate behavior. A pregnant person can spread the virus to their fetus through the placenta. It is also possible to contract monkeypox via contact with infected animals; however, person-to-person contact is the primary mode of transmission.
Linens, towels or clothing that touched the infectious rash or bodily fluids can also transmit the virus.
The majority of diagnosed cases of monkeypox in the U.S. have been found among men reporting sexual intimacy with other men, but anyone can catch the virus through close contact with an infected person. Two cases of monkeypox among children have been identified in the United States, representing less than 0.1% of all cases.
Signs and Symptoms
People with monkeypox get a rash, which can look like pimples or blisters.
This rash can appear before or after flu-like symptoms, including a fever.
The rash that people develop can be a single sore or more widespread. It may be located on or near the genitals or anus, or on the hands, feet, chest, face or mouth. Monkeypox sores are frequently painful or itchy.
Symptoms appear 5 to 21 days after exposure to the virus. If the flu-like symptoms appear first, the rash will follow 1 to 4 days later.
People with monkeypox remain contagious until their lesions scab and fall off completely. This period lasts between 2 and 4 weeks, and people with the virus should isolate during this time. Unlike COVID-19, only people with symptoms can transmit the virus.
Prevention and Treatment
Monkeypox is genetically similar to smallpox, so treatments and vaccines used for smallpox can be used to prevent spread and treat monkeypox virus infections.
Prevent: Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox and isolate contaminated items like bedding, clothes and towels until they have been laundered. Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom. CDC also recommends limiting the number of sexual partners, avoiding kissing and keeping clothes on during intimacy to minimize skin-to-skin contact.
If you have a new or unexplained rash or other symptoms, CDC recommends that you avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
Vaccinate: CDC recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox, including:
• People who have been identified by public health officials as a contact of someone with monkeypox
• People who are aware that one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
• People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox
• People whose jobs may expose them to orthopoxviruses, such as laboratory workers and designated healthcare and
public health workers
Treat: When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area. If your test result is positive, stay isolated until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.
Antivirals may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.
In the meantime, use gauze or bandages to cover the rash. Do not pop or scratch lesions and do not shave the area with the rash until scabs have fallen off. Wear a well-fitting mask when you go out.
For more details on treatment, see https://www.cdc.gov/poxvirus/monkeypox/if-sick/what-to-do.html
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